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trials.gov Identifier NCT00090064, NCT00353938, NCT01958593, NCT01211405, NCT01689740, NCT01793610.The research about finding the effective membrane material is in progress; however, there are pros and cons for each material. Graphene membrane is a single layer of atoms in a two-dimensional hexagonal lattice which achieved high performance in water purification field. Addition of TiO2 to the graphene membrane has been studied for the membrane modifications due to its high stability and photocatalytic performance. In this study, graphene/TiO2 bilayer nanocomposite membrane has been simulated to enhance the mechanical and electronic properties of graphene membrane. Anatase TiO2 (A-TiO2), rutile TiO2 (R-TiO2), and their composite with graphene (G) have been simulated to evaluate the stability of the nanocomposite bilayers in water desalination for higher salt rejection percentage and water permeation. The membrane structure has been created and optimized using the geometry optimization task. The simulation of electronic and mechanical properties has been done by using Material Studio 2019. TiO2 consisting rutile and anatase phases showed a band gap of 2.248 eV, which was reduced to 1.175 eV in combination with graphene. The bilayer composite of TiO2 and graphene achieved higher membrane stability, and the salt rejection was 98% under applied pressure of 100 MPa. The graphene/TiO2 bilayer nanocomposite membranes have been evaluated by simulation for water desalination process using molecular dynamics by ReaxFF software. In comparison with a graphene membrane, the results showed an increment in salt rejection and water permeability under different applied pressure.Purpose Personalised information and support can be provided to cancer survivors using a structured approach. Needs assessment tools such as the Holistic Needs Assessment (HNA) in the UK and the Comprehensive Problem and Symptom Screening (COMPASS) questionnaire in Canada are recommended for use in practice; however, they are not widely embedded into practice. The study aimed to determine the extent to which nurses working in cancer care in the UK and Manitoba value NA and identify any barriers and facilitators they experience. Method Oncology nurses involved in the care of cancer patients in the UK (n = 110) and Manitoba (n = 221) were emailed a link to an online survey by lead cancer nurses in the participating institutions. A snowball technique was used to increase participation across the UK resulting in 306 oncology nurses completing the survey in the UK and 116 in Canada. Results Participants expressed concerns that these assessments were becoming bureaucratic "tick-box exercises" which did not meet patients' needs. Barriers to completion were time, staff shortages, lack of confidence, privacy, and resources. Facilitators were privacy for confidential discussions, training, confidence in knowledge and skills, and referral to resources. Conclusion Many busy oncology nurses completed this survey demonstrating the importance they attach to HNAs and COMPASS. The challenges faced with implementing these assessments into everyday practice require training, time, support services, and an appropriate environment. It is vital that the HNA and COMPASS are conducted at optimum times for patients to fully utilise time and resources.Purpose The current project was developed to obtain natural history information regarding cisplatin-induced peripheral neuropathy in males with testicular/germ cell cancers and to compare such neuropathy data with similarly obtained data in patients receiving other chemotherapy drugs in similarly conducted clinical trials. Methods Patients without baseline neuropathy symptoms, who were initiating cisplatin-based chemotherapy, completed the EORTC CIPN 20 patient-reported instrument to evaluate chemotherapy-induced peripheral neuropathy (CIPN). Results were compared with EORTC CIPN 20 data obtained from independent study sets regarding patients receiving (1) paclitaxel, (2) combined paclitaxel and carboplatin, (3) oxaliplatin, or (4) a combination of doxorubicin and cyclophosphamide (AC). The last study set of patients on AC was selected to evaluate the use of EORTC CIPN 20 data in patients receiving chemotherapy not known to cause CIPN. Results Cisplatin-induced neuropathy was more similar to neuropathy in patients receiving oxaliplatin than in those receiving paclitaxel. The cisplatin and oxaliplatin groups exhibited the coasting phenomenon and more prominent upper extremity symptoms than lower extremity symptoms during chemotherapy administration weeks. In contrast, paclitaxel-treated patients did not, on average, exhibit the coasting phenomenon; additionally, lower extremity symptoms were more prominent during the weeks when paclitaxel was administered. Cisplatin-induced neuropathy was less severe than was seen in patients in the other two groups, potentially because the cisplatin-receiving patients were younger. Patients receiving AC did not report substantial EORTC CIPN 20 changes. Conclusion Understanding neuropathy similarities and differences with various chemotherapy agents may help elucidate CIPN processes and facilitate means to prevent and/or treat established CIPN. Trial registration NCT02677727.Inflammatory bowel disease (IBD) has been associated with underweight and malnutrition, but obesity may also serve as a negative prognostic factor. This study aimed to present the longitudinal course of height, weight, and body mass index (BMI) of children from IBD diagnosis to 18 months of follow-up, and to describe the impact of BMI on the clinical course of the disease. One hundred and fifty-two children were identified, of whom 85 had Crohn's disease (CD) and 67 had ulcerative colitis (UC). During a median (interquartile range) follow-up of 2.95 (1.73-4.5) years, weight and BMI Z-scores increased in the first 18 months since diagnosis in both the CD (P less then 0.001) and UC (P less then 0.028) groups. BMI in lower and upper quartiles at diagnosis was associated with higher risk of hospitalization (hazard ratio [HR] = 2.72, P = 0.021). In a multivariate analysis, BMI in the lower quartile at diagnosis and at 6, 12, and 18 months was associated with higher risk of disease exacerbation (HR = 2.36, 1.90, 1.98, and 2.43, respectively, P less then 0.021), as was BMI in the upper quartile (HR = 2.59, 2.91, and 2.29, respectively, P less then 0.013).Conclusion BMI in the lower and upper quartiles at diagnosis and during follow-up was associated with a more severe disease course in children with IBD.What is Known• Inflammatory bowel disease (IBD) has been associated with underweight and malnutrition.• The impacts of weight and body mass index (BMI) on the presentation and course of IBD have been mainly investigated in the adult population.What is New• In the era of the obesity epidemic, this study identifies both low and high BMIs at diagnosis and at follow-up as a marker for poor outcome in pediatric IBD.• The results support using BMI as a predictor of IBD course and prognosis.The Rescorla-Wagner (R-W) model describes human associative learning by proposing that an agent updates associations between stimuli, such as events in their environment or predictive cues, proportionally to a prediction error. While this model has proven informative in experiments, it has been posited that humans selectively attend to certain cues to overcome a problem with the R-W model scaling to large cue dimensions. We formally characterize this scaling problem and provide a solution that involves limiting attention in a R-W model to a sparse set of cues. Given the universal difficulty in selecting features for prediction, sparse attention faces challenges beyond those faced by the R-W model. We demonstrate several ways in which a naive attention model can fail explain those failures and leverage that understanding to produce a Sparse Attention R-W with Inference framework (SAR-WI). The SAR-WI framework not only satisfies a constraint on the number of attended cues, it also performs as well as the R-W model on a number of natural learning tasks, can correctly infer associative strengths, and focuses attention on predictive cues while ignoring uninformative cues. Given the simplicity of proposed alterations, we hope this work informs future development and empirical validation of associative learning models that seek to incorporate sparse attention.Background The thumb's radial collateral ligament (RCL) plays an important role in stabilizing the first metacarpophalangeal joint (MCP-1). RCL injuries are rare and treatment recommendations are inconsistent in the current literature. The aim of this study was to report on long-term outcomes following surgical repair of thumb RCL tear and to identify prognostic risk factors for treatment failure. Methods Patients with RCL tear from 10/1998 to 10/2019 were included in the present retrospective single center cohort study. In follow-up visits, participants were assessed regarding pain, range of motion and strength as well as with disability of shoulder, arm and hands (DASH), and the Short-Form 36 (SF36) questionnaires. Finally, predictive factors of postoperative deficits were identified. Results 43 patients fulfilled inclusion criteria. Median age was 43.5 years (range 18-80 years). check details The most frequent mechanism of injury was a fall or impact. Bony avulsions were identified in 46.5% (20/43). Time from injury to surgery was 12 days (0-276 days). One Stener-like lesion was observed intraoperatively among our patients. After surgical repair, the MCP-1 joint was stable in every patient. Mean time to follow-up was 5.3 years (1 month to 17 years). Persistency of pain in the MCP-1 joint was reported by 11 patients. Postoperative averaged score was 3.75 on DASH and 44.96 on SF36, respectively. The average grip and pinch strength was 32.7 kg and 8.37 kg, respectively. link2 Predictive factors of postoperative deficits were delay of surgery of > 3 weeks (OR 10.72, p 0.017) and palmar subluxation prior to surgery (OR 8.86, p 0.019). Conclusion Long-term follow-up has proven that surgical repair of RCL enables the patient to regain adequate stability and strength of the MCP-1 joint and minimizes disability. Predictive risk factors of pain persistency after surgery are surgical delay and palmar subluxation of the MCP-1 joint.Unconventional oil and gas (UOG) drilling has expanded rapidly across the United States, including in the Fayetteville Shale formation in north-central Arkansas where drilling began in 2004. As one of the oldest regions of UOG activity in the United States, this area has experienced significant land-use changes, specifically development of natural habitat and agricultural land for gas infrastructure. In recent years, drilling of new wells has stopped and production has declined. By 2017, 1038 wells had ceased production and been abandoned, which makes them eligible for land reclamation. However, most of these sites (80%) have not been reclaimed and continue to cause losses in ecosystem services. link3 If reclamation was performed on lands associated with abandoned infrastructure, we estimate more than $2 million USD annually in agricultural, timber, and carbon sequestration values would be gained. These benefits far outweigh the costs of reclamation, especially since the benefits accrue over time and reclamation is a short-term cost.

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